AREDIA

*Hypercalcaemia of malignancy:* BY IV INF: Adult: 15-60 mg, to be given via cannula in a relatively large vein as a single INF or in divided doses over 2-4 days, dose adjusted according to serum calcium concentration; max. 90 mg per course. *Osteolytic lesions and bone pain in bone metastases associated with breast cancer or multiple myeloma:* BY IV INF: Adult: 90 mg every 4 weeks, to be administered via cannula in a relatively large vein, dose may alternatively be administered every 3 weeks, to coincide with chemotherapy in breast cancer. *Pagets disease of bone:* BY IV INF: Adult: 30 mg every week for a 6 week course (total dose180 mg), alternatively initially 30 mg once weekly for 1 week, then increased to 60 mg every 2 weeks (max. per dose 60 mg) for a 6 week course (total dose 210 mg), to be administered via cannula in a relatively large vein, course may be repeated every 6 months; max. 360 mg per course Adults: Capsule: 200 mg daily. Children: Not recommended.

Drug must be properly diluted before administration and slowly infused IV (over at least 2 hours). RECONSTITUTION: Powder for injection: Reconstitute by adding 10 ml of sterile water for injection to each vial of lyophilized pamidronate disodium powder, the resulting solution will be 30 mg/ ml or 90 mg/ ml. Pamidronate may be further diluted in 250-1000 ml of 0.45% or 0.9% sodium chloride or 5% dextrose.

Renal impairment, cardiac disease, previous thyroid surgery, atypical femoral fractures. Ensure adequate hydration, possibility of precipitating convulsions. Monitor serum electrolytes, calcium and phosphate during prolonged use, monitor renal function.

Infusions of solutions containing calcium, hy-pocalcaemic therapy, other diphosphonates, plicamycin.

Abdominal pain, anaemia, anorexia, arthralgia, bone pain, constipation, diarrhoea, drowsiness, fever, headache, hypertension, hypomagnesaemia, hypophosphataemia, influenza- like symptoms, insomnia, myalgia, nausea, paraesthesia, rash, symptomatic hypocalcaemia, tetany, thrombocytopenia, vomiting, mild transient pyrexia, transient lymphocytopenia, infusion site reactions, Rarely, leucopenia, anaemia, other biochemical disturbances.